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What is Fetal Alcohol Spectrum Disorders?

Fetal Alcohol Spectrum Disorders (FASD) is the result of a pregnant woman having one or more drinks during pregnancy. No amount of alcohol has been proven safe at any time during pregnancy. You should not drink alcohol if you are pregnant, trying to get pregnant or think you may be pregnant. There’s really no safe time to drink alcohol during pregnancy. Alcohol can cause problems for your baby. Many women are not even aware they are pregnant in the first six weeks.

Of course, alcohol is not the only substance that can cause an issue for women during pregnancy. Any substance consumed during pregnancy plays a role in a child’s development. The only known cause of Fetal Alcohol Spectrum Disorders (FASD) is prenatal alcohol exposure. Alcohol is a teratogen that crosses the placenta and can damage the central nervous system (including the brain) and other organs of the developing baby. Other substances when taken during pregnancy increases the chances of birth defects, premature babies, low birth weight and miscarriage

Signs of FASD

A child with FASD may have:

  • Low body weight
  • Poor coordination
  • Hyperactive behavior
  • Difficulty with attention
  • Poor memory
  • Difficulty in school (especially math)
  • Learning disabilities
  • Speech and language delays
  • Intellectual disability or low IQ
  • Poor reasoning and judgement skills
  • Sleep and sucking problems as a baby
  • Vision or hearing problems
  • Problems with heart, kidneys or bones
  • Shorter-than-average-height
  • Small head size
Abnormal facial features, such as a smooth ridge between the nose and upper lip (this ridge is called the philtrum)

FASD infographic.pdf

A diagnosed FASD child will be classified under one of four umbrella terms

  • FAS (Fetal Alcohol Syndrome)- People with FAS have the most severe central nervous system (CNS) dysfunction, the presence of the classic characteristic facial features, significant growth deficiency and confirmed severe prenatal alcohol exposure.
  • PFAS (Partial Fetal Alcohol Syndrome)- The term “Partial FAS” is used when a person’s characteristic features are very close to the classic features of FAS and the alcohol history strongly suggests that alcohol exposure during pregnancy was at high level and likely to have played a role in person’s difficulties.
  • ARND (Alcohol Related Neurobehavioral Disorder)- This is the most common diagnosis on the spectrum. People with ARND have some but not all of the characteristic growth deficiency, characteristic facial features, and CNS damage/ dysfunction, but a number of other factors could be contributing to the present issues. Present issues may be genetic background, other potential exposures or problems during gestation, and various experiences since birth.
  • ARBD (Alcohol Related Birth Defects)- This is the least common diagnosis on the spectrum. These individuals have the growth deficiency and/or facial characteristics that to some extent are compatible to FAS, but do not have clear evidence of cognitive or behavioral problems that strongly suggest CNS damage/ dysfunction.

If a child falls under one of the umbrella terms, is there a treatment for each one? Dr. Williams said, “FASD conditions are life-long. There is no cure for FASD, but research shows that early intervention treatment services can improve a child’s development. There are many types of treatment options, including medication to help with some symptoms, behavior and education therapy, parent training and other alternative approaches. No one treatment is right for every child. Each child with FASDs have unique strengths and challenges, but they all share the same basic needs and desires we all do: to be cared about, to be heard and understood, to make a difference, and to contribute to their families and communities. Helping a person to live successfully with FASD means recognizing strengths and focusing on ability over disability. Good treatment plans will include close monitoring/supervision, follow-ups, flexibility/changes as needed along the way, and needing to frequently repeat and rehearse skills.”

As previously mentioned, FASD may affect a child’s performance in school. Some common challenges for educators who teach students with FASD include hyperactivity, impulsivity, attention and memory deficits, difficulties with completing tasks, disruptive behaviors, difficulties with social skills, and the need for constant supervision and close monitoring.

Successful strategies for educating children with FASD include using concrete, hands-on learning methods, establishing structured routines, keeping instructions short and simple, providing consistent and specific directions, frequently repeating instructions and rehearsing tasks, and providing constant supervision.

Once strategies and coping skills are mastered, the next step is helping a person to live successfully with FASD. As mentioned previously, this means recognizing strengths and abilities of the person, rather than overly focusing on deficits and challenges. The focus should be on competencies, relationship mutuality and working with, rather than talking at the teen/ young adult. We all require help from others in varying degrees and most of us live interdependently in our communities. The focus for individuals with FASD should be on interdependence to support success.